Four Patterns in End-of-Life Decline?

International cohort study found physical function declined most rapidly before mortality, while socioeconomic status was associated with more favorable multidomain trajectories.

By
Andrea Surnit
July 21, 2026
4 min

MDSpire News

At a Glance

Category	Detail
Condition	End-of-Life Decline
Key Mechanisms	Declines in physical, cognitive, and psychological functioning during the final decade of life.
Target Population	Adults aged 45 years or older from 17 countries.
Care Setting	Longitudinal analysis of health data.

Key Highlights

Decedents experienced steeper declines in physical, cognitive, and psychological functioning compared to survivors.
Physical functioning showed the greatest deterioration, especially as mortality approached.
Four distinct patterns of decline were identified among decedents.
Higher socioeconomic status was associated with lower odds of unfavorable decline trajectories.
Educational attainment had a stronger association with favorable trajectories than household income.

Guideline-Based Recommendations

Diagnosis

Early screening to identify overall functional impairment.

Management

Strategies to reduce accelerated functional decline should start before old age.

Monitoring & Follow-up

Identifying co-decline patterns may inform targeted strategies.

Risks

Socioeconomic status may increase the likelihood of unfavorable multidomain patterns of decline.

Patient & Prescribing Data

Adults aged 45 years or older.

Focus on promoting healthy longevity and reducing end-of-life health inequalities.

Clinical Best Practices

Conduct regular assessments of physical, cognitive, and psychological functioning.
Implement interventions tailored to socioeconomically disadvantaged groups.